NEONATAL ENTEROVIRUS INFECTION - VIROLOGY, SEROLOGY, AND EFFECTS OF INTRAVENOUS IMMUNE GLOBULIN
NEONATAL ENTEROVIRUS INFECTION - VIROLOGY, SEROLOGY, AND EFFECTS OF INTRAVENOUS IMMUNE GLOBULIN
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DOI：
10.1093/clinids/20.5.1201
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发表时间：
1995-05-01
影响因子：
11.8
通讯作者：
ROTBART, HA
中科院分区：
文献类型：
--
作者：
ABZUG, MJ;KEYSERLING, HL;ROTBART, HA
16例新生儿肠道病毒感染的病毒学及血清学反应的前瞻性研究在研究开始时，11名新生儿没有可检测到的针对其自身病毒分离株的血清中和抗体，尽管这些婴儿的11名母亲中有9名存在中和抗体，分别在8例和7例新生儿中证实了病毒血症和病毒尿，最大检测滴度分别为6.3 × 10（3）50%组织培养感染剂量/mL（TCID 50）和6.8 × 10（1）TCID 50/mL。病毒血症与出生后5天内发病、初始血清中和滴度低和埃可病毒血清型的存在相关，随机给予静脉注射免疫球蛋白（IVIG; 750 mg/kg）对9名新生儿总体上适度增加血清中和滴度，但与对照组相比，没有降低病毒血症和病毒尿的每日发生率。接受对患者自身病毒分离株的中和滴度大于或等于1：800的IVIG与显著更高的血清中和滴度和更快地停止病毒血症酸性病毒尿相关。IVIG用于新生儿肠道病毒疾病的未来试验应评估更高或重复剂量的该试剂和/或选择高滴度的IVIG批次对频繁循环和/或特别强毒的肠道病毒血清型的有效性和安全性。
A prospective study of the virology of and serological responses to enterovirus infection in 16 neonates (less than or equal to 2 weeks of life) and their mothers was performed, At study entry, 11 neonates did not have detectable serum neutralizing antibody to their own viral isolates, despite the presence of neutralizing antibody in 9 of 11 mothers of these infants, Viremia and viruria were demonstrated in 8 and 7 neonates, respectively, with maximal detected titers of 6.3 X 10(3) 50% tissue culture infective dose per mL (TCID50) and 6.8 X 10(1) TCID50/mL, respectively. Viremia was associated with onset of illness in the first 5 days of life, low initial serum neutralization titer, and the presence of echovirus serotypes, Randomized administration of intravenous immune globulin (IVIG; 750 mg/kg) to nine neonates overall modestly increased serum neutralization titers but did not reduce the daily incidence of viremia and viruria compared with that of controls, However, receipt of IVIG containing a neutralization titer of greater than or equal to 1:800 to the patients' own viral isolates was associated with significantly higher serum neutralization titers and more rapid cessation of viremia acid viruria, Future trials of IVIG for neonatal enterovirus disease should assess the efficacy and safety of higher or repeated doses of this agent and/or of IVIG lots selected for their high titers to frequently circulating and/or particularly virulent enterovirus serotypes.